MEDICARE: ABOUBAKAR SHARAF MBBCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084V0102X	Vascular Neurology Physician	60576	MN
2	2084N0400X	Neurology Physician	60576	MN

General Provider Information

NPI Number	:	1548572647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABOUBAKAR SHARAF MBBCH

Provider Business Mailing Address
First Line	:	9645 GROVE CIR N STE 100
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-2682
Country	:	US
Telephone Number	:	763-302-4114
Fax Number	:

Provider Business Practice Location Address
First Line	:	9645 GROVE CIR N STE 100
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-2682
Country	:	US
Telephone Number	:	763-302-4114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2010
Last Update Date	:	05/19/2022

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Directions to “ ABOUBAKAR SHARAF MBBCH” Practice Location

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